Wasilla Hillbilly:Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity [diseased state] than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism

Yeah so basically once medicine does it's job, it would be helpful if the rest of society didn't treat these folks like outcasts. You're right - that's too big a problem to solve, let's call it a day and eat some pie.

Wasilla Hillbilly:Theaetetus: Wasilla Hillbilly: evilmrsock: I don't think there's any dispute that the surgery typically improves the internal disposition of a transgender identity

Citation needed

Citation of a lack of dispute in the medical community? Citation of a lack of something? Really?How about you find a citation that there is a serious dispute in the medical* community, mmkay?

*note, "medical". Not "political" or "religious".

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity [diseased state] than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism

Note the second variable there. Your study actually fails to support your claim. that there's a dispute regarding surgery for transgenders. Rather, your study suggests that even with surgery, they're still at high risk compared to the general population. That's a different question, you'll note.

Citation of a lack of dispute in the medical community? Citation of a lack of something? Really?How about you find a citation that there is a serious dispute in the medical* community, mmkay?

*note, "medical". Not "political" or "religious".

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity [diseased state] than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism

PubMed source. But, as I noted, this study doesn't compare "transgender without surgery" to "transgender with surgery," but instead "transgender with surgery" to "nontransgender", which is an entirely different variable.

PubMed source. But, as I noted, this study doesn't compare "transgender without surgery" to "transgender with surgery," but instead "transgender with surgery" to "nontransgender", which is an entirely different variable.

Thanks for finding a better source, and you're right that the significance of it is pretty much "nothing" as it's compared to the general public. The Gay community had a lot of bad-looking stats compared to the general population, too, but as societal acceptance has grown, these negative factors have been reducing/reduced. Imagine that.

PubMed source. But, as I noted, this study doesn't compare "transgender without surgery" to "transgender with surgery," but instead "transgender with surgery" to "nontransgender", which is an entirely different variable.

Thanks for finding a better source, and you're right that the significance of it is pretty much "nothing" as it's compared to the general public. The Gay community had a lot of bad-looking stats compared to the general population, too, but as societal acceptance has grown, these negative factors have been reducing/reduced. Imagine that.

I personally find it incredibly shocking that all of the problems of the gay community haven't been solved already. I mean, if they weren't, then we'd expect to see some signs that their issues still exist, like people on public internet forums discussing whether their medical procedures should be paid out of pocket or not, or whether they should be allowed to marry, or whether employers should get to fire them based on their sexual orientation or presentation. Clearly, since such discussions aren't occurring, then everything has been solved and studies that show a worse outcome for transgender people can't have any causes related to social acceptance.

titwrench:LasersHurt: titwrench: LasersHurt: titwrench: LasersHurt: sage37: My fat ass and giant ears give me body dysmorphia, so I am suicidal and a drug abuser. I'm just convinced in my heart that I truly am handsome. Please pay for my surgery. It's the only way I can feel comfortable as a human.

This is not the same, and you know that. You are a bad person.

Why not? There are people that have a psychological need to change their appearance and suffer in their own skin. Whether it is a need to change gender or just a need to change your face or body to look a particular way if it is causing psychological damage why isn't it the same. What if someone was born with cleft lip or had a childhood disorder that left them with a minor deformity that caused them distress in their adult life? Are you trying to say they wouldn't deserve the same opportunity to fix it.

I am saying that his "I don't feel handsome enough plz halp" comment was ridiculous. This is not a comment on the actual merits of psychological issues related to appearance, particularly with "real" problems like a cleft pallet or club foot.

There may be an argument to be had about sexual identity or actual deformities - not his "handsomeness" idiocy.

Why not? Society rewards attractiveness. if being homely causes problems for a person psychologically how is there perception of themselves being uncomfortable in their body any less important than someone that feels they need to change their gender? The emotional and mental need is the same.

No, it's not the same. The pressures felt by someone who is "the wrong gender" is NOT AT ALL the same as the pressures one feels to be attractive. The two are not equal.

Tell that to girls suffering anorexia and bulimia. Their need to "fix" themselves is just as damaging psychologically as someone that feels the need to change gender. To person suffering the need is no less important as anyone else's. Just because you perceive a nose job as trivial compared to gender reassi ...

People suffering from anorexia and bulimia GET MEDICAL TREATMENT, because those are MEDICALLY ACKNOWLEDGED CONDITIONS. Like gender dysmorphia.

If you disagree with San Francisco here, your issue is with the AMA and DSM. They're the ones deciding what is and is not a medical condition.

Wasilla Hillbilly:evilmrsock: I don't think there's any dispute that the surgery typically improves the internal disposition of a transgender identity

Citation needed

While I thank people that actually tried to research this, I will admit to this being not being a medically informed statement but a logically deduced one: I have never heard of transgender surgery being forcibly done to someone against their will; and I have never heard of a large outcry from the transgender community about banning the practice. I therefore assume that a majority of patients have a positive experience as a result of the surgery, or there would not be a demand for more and it would not be recommended on the basis of positive feedback.

I tried to phrase my statement as loosely as possible - typically improves internal disposition - to not imply that it always improves their physical lot in life, which if you could show, would go a long way in stating that this would be money well spent. I'd personally not support it because I'd rather that pool of money go into more globally applicable tools - shiat, increased coverage for hormone treatments (which have more varied uses), side by side, same dollars spent, I'd pick that over this and it'd still help the intended audience. But that's different than not supporting because it doesn't effect you or people you personally know so you don't recognize it as being a problem yet (see: aids, homosexuality not being a choice, autism being a spectral disorder, and other things that magically become important once it tangentially effects someone you know).

Citation of a lack of dispute in the medical community? Citation of a lack of something? Really?How about you find a citation that there is a serious dispute in the medical* community, mmkay?

*note, "medical". Not "political" or "religious".

Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity [diseased state] than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism

PubMed source. But, as I noted, this study doesn't compare "transgender without surgery" to "transgender with surgery," but instead "transgender with surgery" to "nontransgender", which is an entirely different variable.

My point wasn't so hard to make as all that. I think i've shown that there are enough people out there that regret having it done for various reasons that saying "the surgery typically improves the internal disposition of a transgender identity" is a dubious claim.

I'm not a bigot, or at leat I try not to be. I've know and cared for transgendered people on a number of occasions. In my limited scope, happiness is not the standard result of all this.

If you could find some data suggesting otherwise that would be great. I don't have a concrete set of beliefs regarding this. Merely that I felt the initial claim I quoted was perhaps ill-informed. But, then again maybe not, thus the request of "citation needed".

Simplicity:I think part of the problem is that there is a misunderstanding about the preconditions to get this surgery. It's not like plastic surgery where you go make an appointment with a doc and have an outpatient procedure or something along those lines. From my understanding you need a psych evaluation and you need to live like your target gender for a period of time. You also just cannot fly into SF claim residency and wait on your castration line... It's not like penises and vaginas are being given out like Halloween presents in the Castro....

The waiting period and psych evaluation are in theory. I worked with a guy who got her SRS within 5mos of transitioning. Before that he never show any indication of being transgender and he lied to the psychiatrist about when he started living as a woman.

I'm all for public money going to keeping you from dying, or developing a disease that prevents you from supporting yourself. Hell, some national single-payer for basic care would be nice. But pay for your elective cosmetic surgery out of your own damned wages like everyone else.

What about a child born with a cleft palate whose parent's are too poor to afford the procedure? Would you have them live with it until they're in their mid 20's and have a job with private insurance that would cover the procedure (and by extension, exposing them to two decades of taunting from their peers and stares from strangers when they go out in public)?

/If you answer no, you're a hypocrite since a cleft palate and gender dysphoria are both valid recognized medical conditions.//If you answer yes, you're probably a terrible person.

LasersHurt:titwrench: LasersHurt: titwrench: LasersHurt: sage37: My fat ass and giant ears give me body dysmorphia, so I am suicidal and a drug abuser. I'm just convinced in my heart that I truly am handsome. Please pay for my surgery. It's the only way I can feel comfortable as a human.

This is not the same, and you know that. You are a bad person.

Why not? There are people that have a psychological need to change their appearance and suffer in their own skin. Whether it is a need to change gender or just a need to change your face or body to look a particular way if it is causing psychological damage why isn't it the same. What if someone was born with cleft lip or had a childhood disorder that left them with a minor deformity that caused them distress in their adult life? Are you trying to say they wouldn't deserve the same opportunity to fix it.

I am saying that his "I don't feel handsome enough plz halp" comment was ridiculous. This is not a comment on the actual merits of psychological issues related to appearance, particularly with "real" problems like a cleft pallet or club foot.

There may be an argument to be had about sexual identity or actual deformities - not his "handsomeness" idiocy.

Why not? Society rewards attractiveness. if being homely causes problems for a person psychologically how is there perception of themselves being uncomfortable in their body any less important than someone that feels they need to change their gender? The emotional and mental need is the same.

No, it's not the same. The pressures felt by someone who is "the wrong gender" is NOT AT ALL the same as the pressures one feels to be attractive. The two are not equal.

Exactly. I don't care whether or not I'm the hottest/most graceful/etc. woman; the only thing I care about is living in a body that I can feel comfortable in. I started taking spironolactone on prescription a month ago and already feel more at peace with myself than I ever remember being. I already feel like I can take pride in myself and my home and feel more comfortable around people.

Cosmetic? No, I just want to feel normal and the less of a guy I have to feel like the better.

Z-clipped:Frank N Stein: Fact of the matter is, you can cosplay all you want. Just don't expect it to be on the public dime.

No, that's your opinion. The fact of the matter is actually pretty much the exact opposite of what you said.The world must be a frustrating place for you.

Dafatone: People suffering from anorexia and bulimia GET MEDICAL TREATMENT, because those are MEDICALLY ACKNOWLEDGED CONDITIONS. Like gender dysmorphia.

If you disagree with San Francisco here, your issue is with the AMA and DSM. They're the ones deciding what is and is not a medical condition.

THIS is the "fact of the matter".

I'm not sure how anyone could say that and honestly believe it.

The topic at hand isn't whether gender dysmorphia is real or not. If we were debating that, certainly the AMA and DSM would be relevant sources. But we're talking about a particular city deciding to provide surgery for uninsured residents, on the taxpayer's dollar.

The stance of the AMA or DSM is irrelevant when discussing what should and shouldn't be covered types of treatment for a particular medical condition. Very few people are lucky enough to be completely free of medical conditions and many treatments are prohibitively expensive. For example, being near-sighted/far-sighted are both very real medical conditions. That doesn't necessarily mean we hand out free eye-surgery coupons to every resident in the city.

Or maybe it does, if that's your stance on it. But the discussion is whether or not all treatements for all medical conditions should be covered.

The AMA/DSM views on whether gender dysmorphia are real or not is ONLY relevant if you can get everyone to agree that *all treatment* for *all medical conditions defined by the AMA/DSM* should be given to uninsured residents.

That's a huge, huge, huge leap in logic. I'm not claiming it's wrong or bad; if you hold that belief that's fine, I'm sure some people do. It just doesn't seem appropriate to argue that the AMA or DSM is the one to blame here.

Theaetetus:machoprogrammer: titwrench: Why not? There are people that have a psychological need to change their appearance and suffer in their own skin.

There are countless men out there who feel they aren't muscular enough. Should the government pay for their steroids, too?

There are countless women out there who feel they don't have big enough boobs/ass. Should the government foot that bill, too?

Are those countless men and women depressed to the point of being suicidal? Then, yes, the government should. What is it about "medically necessary procedure" you don't understand?

Probably the part where it isn't necessary. It isn't necessary. You aren't going to just cease living if you don't get to be another gender. If you don't want to pay for it then get over it or go farking kill yourself for all I care.

Luckily this is one thing that I don't ever see moving forward. The backlash would be unbelievable over then what constitutes "medically necessary procedures". I would bet even chunks of the LGBT community would think "....uh, no".

Fark_Guy_Rob:The topic at hand isn't whether gender dysmorphia is real or not. If we were debating that, certainly the AMA and DSM would be relevant sources. But we're talking about a particular city deciding to provide surgery for uninsured residents, on the taxpayer's dollar.

Exactly. Specifically, medically necessary surgery.

Fark_Guy_Rob:The stance of the AMA or DSM is irrelevant when discussing what should and shouldn't be covered types of treatment for a particular medical condition.

Nonsense. Those references define current medical consensus. What other reference would take priority when determining which illnesses should be covered? Popular opinion? I think not.

Fark_Guy_Rob:The AMA/DSM views on whether gender dysmorphia are real or not is ONLY relevant if you can get everyone to agree that *all treatment* for *all medical conditions defined by the AMA/DSM* should be given to uninsured residents.

That's a false dichotomy. There are many criteria by which we may decide that an illness is grave enough to require immediate attention and/or public support for treatment.

Fark_Guy_Rob:It just doesn't seem appropriate to argue that the AMA or DSM is the one to blame here.

You've completely misunderstood the context of the post I quoted. Anorexia and bulimia were advanced as life-threatening conditions related to body image. Datafone simply noted that those are covered illnesses, and that, according to the AMA and DSM, gender dysmorphia is at least as grave and "legitimate" a condition. He/she no doubt felt the need to do so because there are numerous knuckle dragging troglodytes int he thread that are desperately trying to pretend that it isn't.

My post was simply drawing attention to the fact that there is an enormous disconnect between reality, and what Frank perceives to be reality.

You make some good points. SF isn't covering all medicine for all citizens or anything. But many of the complaints in this thread are about how gender reassignment surgery isn't "necessary", or is "cosmetic." I'm pointing out that medicine disagrees.

I'm all for public money going to keeping you from dying, or developing a disease that prevents you from supporting yourself. Hell, some national single-payer for basic care would be nice. But pay for your elective cosmetic surgery out of your own damned wages like everyone else.

It's not, however, "elective cosmetic surgery", but a necessary medical procedure, according to the AMA and DSM. If San Francisco is going to cover necessary medical procedures for uninsured residents, then it should cover all such necessary medical procedures, and not second-guess doctors. None of this "oh, sure, your doctor claims you need surgery, but I'm an elected public official with a law degree, so therefore I know more about medicine" bullshiat like you're suggesting.

Britney Spear's Speculum:I'm in favor of LGBT rights as much as the next godless hippy librul, but using tax payer money to fund a non-life sustaining operation is not a good use of funds in my view. With the huge homeless problem in The City, how could anyone in good conscious be in favor of this?

This is a life-sustaining operation, per current medical research and best practices.

Simplicity:My thoughts too. Also add in California's and San Francisco's inability to pay it's bills.

I would like to point out that CA is on track to have a Surplus and SF has never had an 'inability to pay it's bills,' even through the worst of CA's fiscal issues. Hey how about all the states rights' and spending decisions need to be made locally folks stand up for something like this in principle even if you don't agree with the premise?

I work in the CA legal industry. The state is deeply in debt, to the point where they fired all the court reporters at county courthouses a couple weeks ago, and they are starting to look at mass-firings of other court staff like clerks. California as a whole does not have a dime to spare.

San Francisco, on the other hand, has nearly the highest tax rate in the country, mostly to pay for social programs like this. It's a beautiful town, with admirable values, but they are crushing their middle-class citizens to give their income to the lower class and upper class.

The discrimination was particularly blatant in that the department provides and covers hysterectomies for women with cancer, but not for women who choose to transition to men. Likewise, it provides and covers the removal of testicles for men with cancer, but not for men transitioning to women.

So if you don't want your balls removed, they're gone. This is definitely the least empathetic argument you can make in favor of transsexual surgery.

ThatDarkFellow:Theaetetus: machoprogrammer: titwrench: Why not? There are people that have a psychological need to change their appearance and suffer in their own skin.

There are countless men out there who feel they aren't muscular enough. Should the government pay for their steroids, too?

There are countless women out there who feel they don't have big enough boobs/ass. Should the government foot that bill, too?

Are those countless men and women depressed to the point of being suicidal? Then, yes, the government should. What is it about "medically necessary procedure" you don't understand?

Probably the part where it isn't necessary. It isn't necessary. You aren't going to just cease living if you don't get to be another gender. If you don't want to pay for it then get over it or go farking kill yourself for all I care.

Now, I'm not a doctor. I don't presume to have a medical degree. I don't claim to be the final arbiter of whether a medical procedure is necessary or not.... where's your medical degree from?

♬ I'm confident that it can be done in CaliforniaI'm confident that it can be done, because I did it, in CaliforniaI'm confident that it can be done in CaliforniaIn San Francisco...the future doesn't belong to the faint hearted, it belongs to the brave ♬

Snapper Carr:What about a child born with a cleft palate whose parent's are too poor to afford the procedure?

I can't believe you think they are the same thing. You can't hide a cleft palate, it's on your face, it's an obvious deformity, your mouth can't operate correctly unless it's fixed, and it's not something you would ever want to reverse or regret doing.

The world has enough people in it and the last thing we need to do is subsidize mentally ill people mutilating themselves. If they want to do it they have that right, but we don't have to pretend that chopping your penis off makes you a woman. Fixing a cleft palate fixes the problem, mentally ill people that cut off parts of their body still have the same brain they started with. It's sad that they were born that way and may kill themselves, but it's hard to argue that it isn't natural selection at work.

Bomb Mecca:I can't believe you think they are the same thing. You can't hide a cleft palate, it's on your face, it's an obvious deformity, your mouth can't operate correctly unless it's fixed, and it's not something you would ever want to reverse or regret doing.

I didn't say that both conditions are the same. Both surgeries are, however, medically acceptedtreatments for their respective conditions. The original poster's position was "I'm all for public money going to keeping you from dying, or developing a disease that prevents you from supporting yourself". The cleft palate example would not meet his criteria for something that should be publicly subsidized - hence the question.

Bomb Mecca:The world has enough people in it and the last thing we need to do is subsidize mentally ill people mutilating themselves. If they want to do it they have that right, but we don't have to pretend that chopping your penis off makes you a woman. Fixing a cleft palate fixes the problem, mentally ill people that cut off parts of their body still have the same brain they started with. It's sad that they were born that way and may kill themselves, but it's hard to argue that it isn't natural selection at work.